Money for neglected disease research up by half a billion dollars

A new study looks into funding research on neglected diseases and finds some changing patterns in how the money is given and spent. The amount of money being contributed has increased over the last five years by half a billion dollars. Seventy percent of all the money contributed is made by only a few organizations; including the National Institutes of Health, and the Bill & Melinda Gates Foundation. The fact that a few groups from the United States make a vast majority of research funding is worrying to the authors of this report.


From the Inter Press Service, writer Carey Biron looks into the research.  

Although overall funding for neglected diseases has gone up by 443.7 million dollars, to about 2.9 billion dollars, since 2007, both public and philanthropic shares have gone down substantially. This is worrisome given that the public sector continues to make up around two-thirds of international funding for such research, almost all from high-income countries, and more than half of the top 20 governments cut their funding for such research in 2011 alone.

While the U.S. government remains the single largest public funder of research into neglected diseases (following only the Gates Foundation), Washington too cut its outlay in 2011, down 2.2 percent to around 30.6 million dollars.

“Some governments now appear to be in it for the long haul, which is great,” Dr. Mary Moran, one of the report’s authors and the executive director of Policy Cures, a London-based research group that published the G-FINDER, said Monday in unveiling the report.

“But we’re worried that their investment model seems to be shifting back to the ‘bad old days’, where the public sector funded basic research leaving product development to industry or philanthropy – and consequently almost no medicines, vaccines or diagnostics for neglected diseases were developed. This model doesn’t and can’t work for truly neglected non-commercial diseases.”

According to findings by Policy Cures, over the past five years, public money for basic research has increased by more than a quarter, to around 124 million dollars, and currently makes up about a third of all public investment in neglected diseases. Meanwhile, public investment in the costly and uncertain product development has actually gone down slightly.
Moran compares this model to putting a man on the moon, for which one needs both scientists to do the research and someone to actually build the physical rocket.

“Governments need to bite the bullet,” she says. “If they want products for neglected diseases, they need to fund product development as well as basic research, and their funding needs to be linked to what’s happening in product pipelines and to be prioritised based on need.”

Dissapointing test results for anti-Malaria drug RTS,S

The highly anticipated anti-Malaria drug RTS,S has completed its third round of testing. Some of the results were disappointing but not bad enough to stop development of the drug. The tests find that the drug reduces malaria illness by a third in infants. That fell short of expectations for the drug because RTS,S now has the same effectiveness as mosquito bed nets. The manufactures of the drug say that the results mean that RTS,S will have to be given to children a couple of times, once at birth and a booster shot later on.

From the Inter Press Service, writer Carey Biron describes the reaction from the test results. 

The study, funded largely by the Bill & Melinda Gates Foundation, is part of the largest malaria trial ever conducted, taking place in seven African countries. Results were published Friday in the New England Journal of Medicine, a U.S. publication.

While still significant, the results were disappointing in having followed surprisingly positive findings last year, when a similar study suggested that RTS,S was almost twice as effective (47-56 percent) on slightly older children, those five to 17 months old.

If this most recent phase could replicate that level of efficacy among infants, researchers had hoped that RTS,S doses could become incorporated into the standard round of initial vaccinations commonly given to newborns – an approach that has now been proven safe.

“It’s a little frustrating that we’re seeing different levels of protection in different age groups compared to last year and this year,” Andrew Witty, the CEO of GlaxoSmithKline, a major drugs manufacturer and one of the central partners in developing RTS,S, told journalists Friday from London.

“As it turns out, this phase of study was not the final step that I think many people might have hoped. But it’s an important step and takes us further forward towards the goal we’ve been working toward over the past 50 years … this remains the lead and most encouraging candidate vaccine.”

Indeed, the new research constitutes the first time that scientists have found such high efficacy for an anti-malarial vaccine for infants. Witty notes that if the two rounds of study had been reversed, the psychological impact would be far different and the findings would undoubtedly have been widely lauded.

Further, the higher efficacy among the slightly older cohort remains extremely important, given that scientists have found that this age category has greater susceptibility to severe cases of malaria than do infants. While the ease of a single early vaccination would have been the most efficient scenario, researchers say they will now be looking into additional strengthening options, such as giving toddlers a booster later on.

“Two things are very, very encouraging,” Witty says. “One, the trial is successful, despite the fact that it doesn’t achieve quite the high level we would have hoped. Two, the benefit we’ve seen is higher than bed nets, which themselves deliver about 30 percent gain over nothing.”

Treatment for a drug resistant strain of malaria could be years away

A new strain of drug resistant malaria is growing in Thailand and Myanmar. As of yet, there are no new drugs developed to treat this strain. It might take years for scientists to develop the new treatment. The development might take even longer because there is still no new funding available for research.

From Reuters Alert Net, we learn more about this gap in combating malaria. 

The strain is resistant to the most effective malaria drug available to doctors – artemisinin. Experts say it has spread because of the incorrect use of artemisinin and fake and substandard versions of the drug.

Doctors have little alternative to artemisinin and it would take years to develop a new malaria drug. They’re worried that if the drug-resistant strain goes unchecked it will spread to Africa where the majority of malaria cases and deaths occur.

Malaria killed 655,000 people in 2010, 90 percent of them in Africa, the majority children.

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In the 1970s and 1980s, strains of malaria that were resistant to previous generations of medicines, such as chloroquine, originated in Cambodia and spread to Africa via Myanmar and India.

The first cases of confirmed artemisinin resistance were found in the late 2000s in western Cambodia along the Cambodia-Thailand border. They have since been reported in Thailand, Myanmar and Vietnam.

“If we don’t care about (this resistance), what will happen is what happened with the chloroquine resistance – more cases, more deaths … We don’t have any products to replace artemisinin,” Fatoumata Nafo-Traore, executive director of Roll Back Malaria, a partnership of U.N. agencies, the World Bank, leading drugmakers and aid experts, said.

“What needs to be done is to say, ‘Now we have a small window of opportunity to contain it and let’s contain it’,” said Nafo-Traore, who was in Thailand prior to the Malaria 2012 summit in Sydney which began on Oct. 31.

One of the main challenges is funding.  

Frank Smithuis, a doctor who’s worked in Myanmar since 1994, criticised donors in an earlier interview with AlertNet, saying Cambodia, Thailand and Vietnam were included in malaria containment programmes but not Myanmar, despite it having the highest malaria burden in the Greater Mekong region.

Donors have traditionally been reluctant to fund programmes in Myanmar for fear of propping up the previous military regime, which ruled for five decades. But a military-backed reformist government which took over last year is generating more goodwill.

The Fight Against Malaria - Successes, Failures

A story from Time Magazine - Malaria has been one of those diseases that has been fought against for a long time. Much $$ has been spent in apparent 'aid' to try to eradicate this disease in third world countries. This article takes a look at why most of those efforts are misguided, and how the latest attempts are succeeding.

Malaria: Epidemic On the Run

"...There are other, more telling statistics, he says, like how in the worst weeks, his handful of staff members may treat 5,000 people. Or how from 2007 to '08, those treated included 70% of all children in Apac and nearly a third of the area's total population..."

Scientists work on mosquito breeding to control malaria

Scientists have just concluded a study that tries to change breeding habits of mosquitoes that carry the malaria virus. Scientists had female mosquitoes breed with sperm-less male mosquitoes to see if it would eventually thin out the number of females that carry the disease.

From Reuters Alert Net, writer Kate Kelland explains the study that was conducted at Imperial College London.

In a study to see how these mosquitoes would fare when trying to get a mate, they found that female mosquitoes cannot tell if the males they mate with are fertile, or spermless and therefore unable to fertilise the females' eggs.

The researchers said findings suggest that in future it might be possible to control the size of the malaria-carrying mosquito population by introducing a genetic change that makes males sterile. Female mosquitoes would then unknowingly mate with the modified males and fail to produce any offspring.

Malaria is a mosquito-borne disease that affects up to 300 million people and kills nearly 800,000 every year. Its threat is greatest in Africa, where the World Health Organisation says a child dies of malaria about every 45 seconds.

Public health experts are working towards the eventual global eradication of malaria, but progress is slow and there is a constant need for better and cheaper ways to get there.

"In the fight against malaria, many hope that the ability to genetically control the mosquito vector will one day be a key part of our armoury," said Flaminia Catteruccia from Imperial's life sciences department, who led the study.

But she added that for these currently theoretical control ideas to work in practice, scientists have to establish whether the insects would continue to mate as normal, unaware that their sexual mechanisms had been tampered with.

Haiti refused malaria vaccinations says drug CEO

A news story breaking this morning gives us another reason to question governance in Haiti. The CEO of a Dutch drug company that makes a malaria vaccine says his offers to give free vaccinations were refused by Haiti. The allegations are made by Ronald Brus the CEO of Crucell, a drug company that makes the malaria vaccine Dukarol

From Top News, writer Davel Wilkins unpacks the details.

He further added that the refused donation could have saved the life of 5,500 by limiting the increase of an epidemic that caused more than 363,000 illnesses, triggering the call for $175m to take action.

The debate also highlighted the fact that what are the main reasons behind the cause of Haiti’s cholera outbreak and how the international institutions can help in removing this problem.

Number of current reports argued that the virus was transported by the UN peacekeepers.

Malaria drug research funding quadrupled over 16 years

The research group Policy Cures has a new analysis of malaria drug research and development that brings some encouraging news. The report says that funding for research has quadrupled over the last 16 years. Policy Cures says the huge influx of funding has helped to develop many possible drugs for the disease. The non-profit group recommends that current funding levels continue. They warn that a drop in donations could prevent those drugs from ever reaching those infected with malaria.

From Reuters Alert Net, writer Kate Kelland unpacks the study on malaria research for us.

The malaria product pipeline currently includes almost 50 drug development projects, one vaccine candidate in late-stage testing -- an experimental shot called RTS,S from GlaxoSmithKline -- and dozens of other vaccine candidates in various stages of development, the report said.

There are also many new insecticide ingredients for mosquito control and a new generation of simple, rapid, and highly sensitive diagnostic tests, it said.

"In the coming years, the fruits of this unprecedented investment in malaria research and development could save hundreds of thousands, if not millions, of lives," said Awa Marie Coll-Seck, executive director of Roll Back Malaria (RBM), which commissioned the report. "This robust product pipeline gives us hope that eradication of malaria is possible."

She added that cutting funding now would be "a foolish waste of a historic opportunity." The total available for R&D in 2009, the latest year for which figures are available, was $612 million.

The report assessed progress against the R&D funding goals in a Global Malaria Action Plan set out by RBM in 2008, and estimated what would be needed in the coming decade to deliver the tools required to control, eliminate and eventually eradicate malaria.

It found that sustained, relatively modest increases are needed to boost annual funding to $690 million by 2015, and then called for a larger jump in 2016 to $785 million.

The challenge of making sure everyone receives the malaria vaccine

The malaria vaccine is due to make its debut within five years. The vaccine developed by Glaxo Smith Kline and the Malaria Vaccine Initiative is just beginning its first clinical trials. After development is done, the task will then shift to how government health ministries will successfully distribute the vaccinations.

From the Inter Press Service writers Joshua Kyalimpa and Terna Gyuse talked to health ministry officials in Uganda about their preparations for the new vaccine.

The debut of a first vaccine against malaria, for example, could now be less than five years away – final testing is under way in seven countries.

Yet developing an effective vaccine is only part of the challenge – effectively integrating it into public health will require careful planning and execution.

The recent history of Africa's immunisation programmes - from the re-emergence of polio in West and Central Africa, to the persistence of meningitis and infant pneumonia - is littered with promising solutions that have failed to have the expected impact. Against a background of poverty and conflict, vaccination campaigns have been hampered by weak infrastructure, insufficient staff or funding, and even popular resistance to vaccinations.

Across the continent, there is new attention to the practical requirements of effective immunisation campaigns. Dr Seraphine Adibaku, head of Uganda's malaria control programme, says his country has already started raising popular awareness of the coming availability of a malaria vaccine, with the most recent meeting of officials from the ministry of health and developers of the vaccine and other stake holders held in May.

"We are conscious not to cause excitement because it can lead to undesirable consequences but we have to tell the people that a vaccine could be here sooner than later," says Adibaku.

Uganda is banking on using infrastructure like ware houses and refrigerators from the Uganda National Expanded Program on Immunisation, which is already in place and has been used on previous immunisation programmes, to roll out the malaria vaccine. Adibaku says training will be given to vaccinators on handling the new vaccine with funding from GAVI, all of which shall be in line with the national vaccination policy.

Adibaku has questions about the vaccine: "We do not know yet for how long the vaccine will offer protection. Do you get protection for six months, one year, or for the rest of your life? These are some on the questions not answered yet."

He says for a vaccine to be effective, it should offer a high level of protection - between 80 and 90 percent - provide long-lasting resistance, and be affordable.

On this last point, Adibaku says a vaccine would be a potent new tool, but worries that high costs could leave poor countries like Uganda unable to make it available.

Guest Voices: Battling Africa’s Number One Killer

Our next installment of guest posts from Concern Worldwide marks the occasion of World Malaria Day. Concern Health Adviser Jennifer Weiss writes about some of the ways that Concern battles malaria infection in children and pregnant women.

According to estimates from the United Nations and the World Health Organization (WHO), nearly one million children do not reach their fifth birthday because they die from malaria each year. Ninety percent of these deaths occur in Africa, where malaria remains the number one killer of young children. An additional 30 million pregnant women and their newborns are also at risk of malaria infection, which may lead to stillbirth, spontaneous abortion, low weight, and neonatal death.

Pregnant women and children die from malaria because they lack access to low-cost, effective solutions to both prevent and treat the disease. Concern is working to change this through our USAID-funded Child Survival programs in Rwanda, Burundi, and Niger, which provide life-saving malaria prevention and control to a total of 1.2 million women and children.

The most obvious way to control malaria is to protect people from being bitten by malaria-carrying mosquitoes in the first place. People are at the highest risk of being bitten at night, while they are sleeping. Therefore, sleeping under a mosquito net, which is treated with a long-lasting insecticide, is a simple solution with dramatic results: at an average cost of about $10, long-lasting insecticide treated bed nets have been shown to reduce malaria transmission by 90 percent.

Concern works with local partner and governments to provide long-lasting insecticide treated nets to the people that need them the most: pregnant women and children under 5 years of age. Concern’s cadre of Community Health Workers then provides one-on-one counseling during household visits to further encourage parents to have their young children sleep under the bed net, and answer any questions or address any challenges the family may be facing in their use.

In Rwanda, Concern’s Child Survival Program is on target to ensure that 85 percent of all households own at least one bed net, and that pregnant women and children under the age of five are sleeping under them each night.

Another life-saving prevention technology recommended by WHO is to provide all pregnant women with at least two preventive treatment doses of an effective anti-malarial drug during routine antenatal clinic visits. Intermittent preventive treatment (IPT), as it is called, has been shown to dramatically reduce maternal anemia and low birth weight, and other adverse effects of malaria during pregnancy. However, many country governments are struggling to provide this service to all pregnant women during their antenatal care visits.

In Niger, Concern’s Community Health Workers are educating mothers about the importance of IPT, and the program is training health facility staff to provide IPT, in order to ensure that 70 percent of all mothers received the recommended two doses of IPT during their last pregnancy.

However, in 2009, only 35 percent of malaria cases were confirmed with a diagnostic test, which requires a skilled laboratory technician and appropriate equipment. Therefore, the majority of malaria diagnoses in sub-Saharan Africa are based on symptoms alone—many of which (fever, difficulty breathing, reduced appetite) are also symptoms of pneumonia. Treatment of pneumonia alone may result in death from malaria, while the unnecessary, ‘presumptive’ treatment of malaria may result in malarial drug resistance.

However, in 2010, the World Health Organization, approved the use of a a new technology, called Rapid Diagnostic Tests (RDTs), which health facility staff may use to make malaria diagnosis without the use of sophisticated laboratory technologies.

In Rwanda, Concern is partnering with the Ministry of Health to conduct the initial roll-out of this ground-breaking tool, and is already seeing improved results: from December 2010-February 2011, Community Health Workers saw a total of 2,944 cases of fever. With the help of RDT, 33 percent were confirmed as cases of malaria and treated accordingly.

For many people, even if a child has been diagnosed with malaria, the nearest health facility is a several hours’ walk away, and parents may not seek treatment until it is too late. Concern’s Child Survival programs bring malaria treatment directly to people who are most vulnerable through an approach called “Community Case Management.” Concern trains Community Health Workers to screen for and treat simple cases of malaria with locally available, effective and safe anti-malarial drugs.

Through the Community Case Management approach in Burundi, Concern is working to increase the percentage of children treated with an effective anti-malaria drug within 24 hours of registering a fever from 26 percent to 60 percent.

Following treatment, the Community Health Worker monitors sick children, and, if they are not improving, ensures that they seek further treatment from the health facility immediately.

Much work remains to be done if we are to significantly reduce the rate of death from malaria worldwide. Concern is contributing to the fight against malaria through the application of proven solutions, as well as new technologies, to reach those most vulnerable to malaria. Preventing the huge numbers of child deaths from malaria that occur each year is no longer an impossible dream.

World Malaria Day is this Monday April 25, 2011. Together, we can save millions of lives.

Sterilizing male malarial mosquitoes

A scientific facility in Vienna is attempting to sterilize male mosquitoes to help lessen malaria. The male's sole purpose in life is to reproduce, so the hope is sterilizing them will reduce the population of malarial mosquitoes.

From the Inter Press Service, writer Timothy Spence explains the process to us.

Entomologists and other researchers at the International Atomic Energy Agency (IAEA) are testing whether sterilised insect technique (SIT) can be used to reduce populations of malarial mosquitoes. Experiments are taking place at the agency’s laboratory facilities in eastern Austria, and researchers emphasise that their work is at an early stage.
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Though the IAEA is better known for inspecting nuclear sites and non- proliferation treaties, its researchers are engaged in other activities, such as using atomic technologies and precision measuring devices to develop more efficient crop irrigation techniques, improve medical diagnoses and calibrate scientific equipment. They also train scientists from developing countries.

The focus of the malaria research so far has been on Anopheles arabiensis, a mosquito species that thrives in the Nile River basin in Sudan. Sudan’s government requested IAEA assistance in reducing the prevalence of malaria in the region. More than 500,000 malaria cases are reported every year in the country of 43 million, and malaria accounts for some 32,000 deaths annually, according to the Global Fund, the public-private partnership that channels money into combating malaria, AIDS and tuberculosis.

Researchers at the Austrian lab have established a colony of the Anopheles mosquitoes that are the target of SIT research. Experiments involve a painstaking process restricted by the relatively short lifespan of the insects - - less than a month -- and the handful of hours when the sterilisation procedure is optimal.

In the lab, the mosquitoes are separated by sex. The males get a blast of up to 100 Gray in a cobalt irradiator, a lethal radiation dose for a human. The sterilised males are then placed in a mesh-covered box where males and females mix in a frenzied mating ritual.

"This is like a crowded discotheque," said Jérémie Gilles, a French entomologist and one of eight researchers working on the project.

SIT has been used successfully to suppress other pests -- often invasive species -- by flooding nature with insects that cannot reproduce.

WHO reports a reduction in malaria infections for Africa

The World Health Organization says that malaria cases have seen big decreases in Sub-Saharan Africa. Some countries have 50 percent reduction in cases of the mosquito borne disease from a few years ago. The WHO attributes that to the increase in use of mosquito nets and drugs.

From the Guardian, writer Sarah Boseley gives us more of the WHO statement and why the improvements are at risk.

Malaria cases or hospital admissions and deaths have been cut by half in 11 African countries over the past decade, the WHO's world malaria report shows. Outside Africa, in 32 of the 56 remaining malaria endemic countries, the gains have been even greater. Eight more countries have seen reductions in the number of cases of between 25% and 50%. Last year Morocco and Turkmenistan were certified malaria free.

"The results set out in this report are the best seen in decades," said WHO director general Dr Margaret Chan. "After so many years of deterioration and stagnation in the malaria situation, countries and their development partners are now on the offensive. Current strategies work."

A huge push to get insecticide-treated bed nets (ITNs) to families in malaria ridden countries over the past three years, involving UN agencies, governments, charities and celebrities, will have supplied approximately 289m nets to sub-Saharan Africa by the end of 2010, which is enough to protect 578 million people – 76% of the 765 million at risk.
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But what the WHO calls the fragility of the gains is clear. By the middle of this year still only 35% of children in Africa – who are the most vulnerable to malaria – were sleeping under a net. "The percentage of ITNs is still below the WHA [World Health Assembly, the supreme decision-making body for WHO] target of 80%, partly because up to the end of 2009 ITN ownership remained low in some of the largest African countries," says the report.

And the lifespan of the nets, at only three years, represents a "formidable challenge", the report goes on. "Nets delivered in 2006 and 2007 are therefore already due for replacement, and those delivered between 2008 and 2010 soon will be. Failure to replace these nets could lead to a resurgence of malaria cases and deaths."

There are other worries. A single class of insecticide is used at the moment in the nets and mostly for indoor spraying. There is a possibility that the mosquito-borne parasites that spread malaria could become resistant to it.

Video: human testing of malaria vaccine

The US Military is conducting human testing of a new vaccine that will help ward off malaria. The vaccine is for a particular malaria strain found in Asia, not the one that we hear so much about in Africa. The military is conducting the trials to try to keep the soldiers serving in Afghanistan from getting sick with malaria.

From the BBC, this fascinating video talks to one of the subjects of the testing.



In the accompanying story, we find out that Sgt. Civitello did get sick from the mosquito bites.

First Sgt Civitello is part of the world's first clinical trial of a vaccine against Plasmodium vivax - the most widespread strain of malaria.

It's not as deadly as Plasmodium falciparum, which is endemic in Africa and kills millions of people, but it can resurface years after infection and still make its victims extremely ill.
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And as predicted, about 10 days after being bitten by mosquitoes in a laboratory, he displayed all the symptoms of malaria.

"It started out with a headache, then a general malaise throughout the day. My eyeballs hurt, and I was really sensitive to cold and hot - my skin was sensitive and I had sweats and chills all night long. It was like extremely bad flu," Sgt Civitello said.

Twenty-seven other volunteers in the study had been given varying doses of the vaccine for several months prior to infection.

Developed by scientists at the Walter Reed Army Institute of Research, it consists of a protein that stimulates the body's immune system and triggers its natural defences against the disease.

US to announce an increase in contribution to the Global Fund

The Obama Administration is expected to announce an increase in the amount the US contributes to the Global Fund for AIDS, Malaria and Tuberculosis. The US is already the largest contributor to the fund, but will begin giving 4 billion dollars over the next three years.

The 4 billion dollars still falls short of the 6 billion that many advocates were hoping for. The increase from the US will still not be enough to offset the decreases made by other governments during the global economic recession.

The US will call for some reforms to the Global Fund with the new money. The US wants the Global Fund to cut waste and to report to the US on any improvements during the next three years.

From the Wall Street Journal, writer Betsy McKay gives us this further description of the announcement.

The U.S.—the largest contributor by far to the Global Fund, with more than $5.1 billion donated since 2002—is pressing the organization to develop an "action agenda" with timelines and measurements, "so that all parties concerned ... can be held accountable," a senior administration official said Monday.

The U.S. will measure progress annually and as it considers contributions beyond 2013, the official said.

The Global Fund accounts for a quarter of international financing to combat HIV/AIDS, and the bulk of funds to fight tuberculosis and malaria. It is seeking to attract at least $13 billion, and as much as $20 billion, from more than 40 countries, private foundations and corporations between 2011 and 2013. Pledges for the past three years totaled $9.7 billion.

Global Fund officials welcomed the anticipated U.S. pledge and the push for reform. "We look forward to working with the U.S. to further enhance reforms we're already undertaking and to listen to any other suggestions for improvements," a spokesman said.

The U.S. pledge represents a 38% increase over the $2.9 billion it contributed between fiscal 2008 and fiscal 2010. Though it has been made for multiple years rather than on an annual basis, the pledge will be subject to Congressional appropriations each year.

Malaria from the flood-waters begins to spread in Pakistan

Large areas of Pakistan remain flooded two months after the disaster began. These large pools of water have become a breeding ground for mosquitoes and malaria is beginning to spread to people who live nearby. The World Health Organization says that there are already 250,000 suspected cases of malaria, while Plan International warns that over 2 million people could soon become infected.

From this Guardian story, writer Declan Walsh gives us the latest update from Pakistan.

Aid agency Plan International worries the figure will surpass 2m. "The most vulnerable are women and children," said its Pakistan director, Haider Yaqub.

The malaria threat is part of a wider health emergency, with more than 20 million people affected by the floods struggling to cope as the winter approaches.

Last night the UN reported 881,000 cases of diarrhoea, 840,000 cases of skin diseases and almost 1m cases of respiratory disorders. Dr Dana van Alphen of the WHO said: "There are no epidemics yet – it's not Goma in 1994. But we have to be very careful."

Increasing UK aid to £134m recently, the international development secretary, Andrew Mitchell, warned of extremely serious public health dangers.

The floods have devastated Pakistan's flimsy public health system. More than 500 clinics have been damaged, while the government estimates that 30,000 "lady health workers" – a programme that is the backbone of the community health system – have been made homeless.

Pregnant woman are a particular concern. An estimated 50,000 flood-affected woman will give birth in the coming month, 7,500 of whom will require surgery for pregnancy-related complications.

New malaria vaccine in final phase of testing

A meeting to discuss malaria prevention begins in Washington today. Scientists attending the meeting are expected to announce good news about a new malaria vaccine. Experts believe that a new malaria vaccine called RTS,S will be in use within five years to treat a deadly form of the disease.

From this AFP article that we found at Google News, we read more about the final phase of testing for the vaccine.

One of the stars at the meeting will be the RTS,S malaria vaccine, which has been developed by GlaxoSmithKline and the PATH Malaria Vaccine Initiative, with funding from the philanthropic foundation set up by Microsoft billionaire Bill Gates and his wife, Melinda.

RTS,S is in Phase III trials, which test a vaccine's safety and efficacy on a large scale, in seven African countries -- Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania. Enrollment is targeted to reach 16,000 children and infants.

Results of Phase II trials, which were announced in 2008, showed RTS,S was 53 percent effective against clinical falciparum malaria in young children, the most vulnerable to the mosquito-borne illness.

In infants, the vaccine was up to 65 percent effective.

If successful, the Phase III testing and licensing of the vaccine would make it a "first generation malaria vaccine that is at least 50 percent effective against severe disease and death, and that lasts more than one year," the Malaria Vaccine Initiative has said.

"This vaccine has been 25 years in the making and it's taken people from all walks of life to pull it together to make it happen," said Oosterbaan.

WHO releases the latest malaria report

From the Voice of America, a story on the latest report from the World Health Organization on malaria prevention efforts.

A new report by health experts at several top universities in the United States and the World Health Organization says money spent on programs to prevent malaria work and have saved the lives of hundreds of thousands of children in 34 African countries over the last 10 years. Details were released Tuesday.

The World Health Organization says malaria kills nearly a million people a year, mostly in Africa, where one in five childhood deaths is related to malaria.

But a new report by leading health experts says increased funding for malaria prevention has made a real difference. It says money spent on insecticide-treated bed nets, indoor spraying and preventative medicine, especially for pregnant women, saved some 736,000 children over the last 10 years. And it predicts millions more will live if funding levels remain stable or increase.

The former U.S. Ambassador to Tanzania, Mark Green, is a long-time advocate for malaria prevention.

"Where progress is made in fighting malaria, money and beds and healthcare workers are freed up to take on other challenges but it goes beyond saving healthcare resources," said Mark Green. "Studies show that scaling up malaria interventions would increase economic output in Africa by as much as $30 billion."

The report's findings are based on data gathered using a computer-based tool that tracked the impact of malaria prevention efforts on child survival from the years 2001 to 2009. Gathering this kind of data has been challenging in Africa and having it helps when fundraising in tough economic times.

"People are looking for things that work, that are measurable, that are verifiable," said Green. "People are generous, but they want to know that the resources that are being allocated are in fact making a difference. And what this report shows to me is precisely that."

The report notes that the number of rural households protected by insecticide-treated bed nets and the indoor spraying of insecticides has increased significantly, tracking alongside the rise in funding and the increased political will to fight the disease.

Dr. Halima Mwenesi is a long-time malaria field worker in Kenya. She says she's truly hopeful for the first time in years.

"We are seeing some accelerated progress now with all the resources that have come in in the last five years especially," said Dr. Mwenesi. "There is huge, huge progress."

The release of the report comes as world leaders head to the United Nations next week to review the so-called Millennium Development Goals aimed at reducing global poverty by 2015. Three of the goals relate directly to malaria - reducing child mortality, maternal mortality and infectious diseases, including malaria.

Modifying yellow fever vaccine to fight malaria

A group of researchers from Rice University have found that modifying the yellow fever vaccine can be used as a malaria vaccine. The modified yellow fever vaccine along with a booster can fend off the effects of malaria in mice. The results of the study were published in the May 6th issue of the journal Vaccine.

From the New Kerala, we read more about the study.

Malaria is one of the most pressing health crises of developing countries: in communities stricken by infection, attendance at work and school drops, and poverty deepens. It has been known since the 1960s that one form of the malaria parasite - called the sporozoite - can wake up the immune system and help to protect against future infection.

The only way to gather sporozoites, however, is to pluck them one-by-one from the salivary glands of irradiated, malaria-ridden mosquitoes.

To provide immunity, the attenuated parasites must then be injected in high doses - or delivered by the bites of hundreds of mosquitoes - a labor intensive approach not feasible for large-scale use.

"We needed to come up with another way to get the benefits of sporozoite immunization," said Charles M. Rice, head of the Laboratory of Virology and Infectious Disease.

Along with researchers from Michel C. Nussenzweig''s Laboratory of Molecular Immunology at Rockefeller and colleagues at New York University, Rice and his team considered that fighting infection with infection might be the key.

They began experimenting with the attenuated yellow fever strain used in the yellow fever vaccine, known as YF17D, which has been used to successfully vaccinate more than 400 million people since 1937.

Previous work in the Rice laboratory and by others had shown that this vaccine strain could be modified to include short sequences from other pathogens, including malaria.

In experiments published last month in Vaccine, the researchers inserted the nearly complete sequence of a malaria gene into the YF17D vaccine and found that the gene could produce its protein in cultured cells.

The most malarial town on earth

The area with the highest concentration of malaria is the Lake Kwania region of Uganda. Lake Kwania is not really a lake, it's more like a giant swamp that is a great breeding ground for malaria carrying mosquitoes.

In a truly great story, Time reporter Alex Perry visited the area. We would encourage clicking the link to the entire story as it goes on to look at solutions, including the organization Malaria No More.

To reach the most malarial town on earth, head north from Kampala, cross the Victoria Nile and, just before you come to the refugee camps that mark the southern edge of Uganda's 20-year civil war, turn east to Lake Kwania. Africa's other Great Lakes are known for freshwater beaches and cool evenings, but Kwania is more of a giant swamp: shallow, full of crocodiles and choked with lily, papyrus and hyacinth. The malaria parasite loves it here.

Kwania's creeks, looking like a million silver fish bones from the air, are perfect for a deadly subspecies of mosquito, Anopheles funestus, which feeds almost exclusively on humans, with an appetite to shame a vampire. The nearby town of Apac is packed with a living blood bank of people. The average funestus bites human flesh 190 times a night. The average resident is bitten tens of thousands of times a year, including 1,586 bites — four a day — that carry malaria. (See TIME's photo-essay "The Most Malarial Town on Earth.")

Driving into Apac late on an August day last year, I saw a naked man lumbering toward me. Tall and thin, he was gray with dust, and his hair bristled with twigs and grass. He was talking to someone only he could see. Edging past, I was surprised by a second naked figure lurching out of a side street. He had the same cracked skin stretched over the same slender frame. Ahead, a third naked figure sat by the side of the road, his head in his hands. I felt as if I'd arrived in a town of zombies.

Apac's empty streets reinforced that impression. The town seemed to exist only for sickness and death: on one road I counted 12 medical centers, 10 drugstores and a crumbling, windowless nursing school. Soon I found a building that belonged to the Ministry of Health. I pulled in, entered and followed a dark corridor to a door marked "District Health Officer." I knocked. Behind two sets of fly screens and under a ceiling fan, Dr. Matthew Emer sat at his desk. I explained I was following a new campaign to rid the world of malaria and was in Apac to see what it was up against. Who were the naked men? I asked. "Brain damage," Dr. Matthew replied. "Severe malaria can do that to a baby. You never recover."

Dr. Matthew thought I should see some statistics. Apac is home to 515,500 people. Between July 2008 and June 2009, 124,538 of them were treated for malaria. That meant 2,000 to 3,000 patients a week for Dr. Matthew and his three fellow doctors, and the number rose to 5,000 in the rainy season. Of Apac's malaria patients, nearly half were under 5. (Read Dr. Mehmet Oz's explanation on why western diseases are spreading around the world.)

Signboards erected by the side of the road announced the presence of two foreign-assistance programs. One was a European-funded child-protection group, which had no malaria component to its program. The other was the National Wetlands Program (NWP), funded by Belgium. Partly because of NWP's influence, the draining of malarial swamps is banned — which amounts to preserving wetlands at the price of human life. Spraying houses with insecticide — which in 2008 cut malaria infections in half — is also forbidden. Why? Because of objections from Uganda's organic-cotton farmers, who supply Nike, H&M and Walmart's Baby George line. Chemical-free farming sounds like a great idea in the West, but the reality is that Baby Omara is dying so Baby George can wear organic.

This, too often, is how aid goes: good intentions sidetracked by ignorance; a promising idea poorly executed; projects that are wasteful, self-regarding and sometimes corrupt. The people being helped often see things this way, as do the ones doing the helping, who ask why the hundreds of billions of dollars given to Africa since World War II have changed so little. It was in the face of such controversy that in 2007 the aid world unveiled one of its most ambitious goals: eradicating malaria.

Disease and it's effects on the MDGs

A recent conference held in Australia talked about the effects of disease in meeting the Millenium Development Goals. Australasian Society for Infectious Diseases’ annual conference talked about the new strains of diseases that are growing resistant to current drugs and treatments. The 350 professionals gathered at the conference also talked about the the challenges of treating major outbreaks of new diseases.

From the Inter Press Service writer Neena Bhandari attended the conference. Our snippet focuses on drug resistant strains of malaria.

Professor Kevin Marsh, director of the Kenya Medical Research Institute Wellcome Trust programme in Kilifi, Kenya, cites the experience of Africa to stress the impact of efforts to fight one of the world’s killer diseases on meeting the MDGs.

"In Africa, if you control malaria, you can reduce childhood mortality down to the levels to achieve MDGs," he says. In coastal Kenya, for instance, malaria has dropped by 90 percent in the last five years and infant childhood deaths have dropped from 115 deaths per 1,000 under-five children to 74 last year, he recounts.

Malaria causes 500 million episodes of illness, almost 40 percent of them in Asia, and one million deaths annually, 90 per cent of them in Africa, says WHO.

"The changing epidemiology of malaria in Southeast Asia, including the emergence and spread of drug-resistant strains of the parasite, are posing fresh challenges to regional elimination efforts," says Professor Ric Price of the Menzies School of Health research in Darwin. "To achieve the ultimate goal of malaria control, we estimate that four to five billion U.S. dollars are needed per year, sustained over the next 20 to 30 years."

Parts of South-east Asia are already witnessing the emergence of malarial strains that are resistant to ‘artemesinins’, drugs the world depends on to treat malaria. If such a situation is not controlled, "it will be a very serious global health issue," warns Marsh, who is also a professor of Tropical Medicine at Oxford University.

There are five species of malaria that commonly infect humans, two of which pose the greatest health risks –‘Plasmodium falciparum’ and ‘P. vivax’ to humans. In Asia, the challenge lies in controlling the ‘P. vivax’ malaria.

The emergence of another species of potentially fatal adult malaria, ‘Plasmodium knowlesi’, has also been noted in the region, particularly in Malaysia. Pig-tailed and long-tailed macaques monkeys are the reservoirs of this parasite, says Timothy William, head of the Infectious Disease Unit at Queen Elizabeth Hospital in Sabah, Malaysia.

"It is difficult to treat or eradicate the reservoirs for obvious reasons. In our study, about 30 percent of the cases presented with severe disease. Therefore it is imperative that these cases are diagnosed early and treated," he says.

New study says climate change will not increase malaria

A new scientific study says that malaria will not increase with climate change. The study printed in the journal Nature, says that current methods of fighting malaria should continue. The researches recommend not letting climate change enter the discussion when talking about dealing with malaria.

From the Montreal Gazette, CamWest News service writer Mark Ivpe tells us more about the study.

"The investment in fighting malaria that is taking place right now will far outweigh the effects caused by the nudge of climate change," said Pete Gething, an epidemiologist with Oxford University and lead author of the study.

Malaria infection takes place when a person is bitten by an anopheles mosquito infected with a single-cell parasite called plasmodium. Once the parasite enters the bloodstream, it matures and multiplies. In just a few hours, it can destroy thousands of red blood cells, leading to severe anemia and sometimes death.
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The researchers' theory was based on work using the various modelling studies that predict the spread of malaria due to climate change. First, they entered data collected during the 20th century, when global temperatures showed a steady rise similar to what is expected with global warming.

Based on those models, areas where malaria is endemic should have expanded - instead, the disease showed a steady decline.

The researchers concluded that modern efforts to fight the disease, combined with improving socio-economic conditions in the developing world, could outweigh the effects of global warming by as much as tenfold.

"We need to focus on dealing with the disease with our current tools," Gething said. "Climate change doesn't need to come into the discussion. It's just a distraction."

Lea Berrang Ford, an epidemiologist at McGill University, said the study's findings might prove correct, but it takes an optimistic view of international development.

"If you believe that conditions in places where malaria is a problem are getting better, then I agree, climate change might not have that big an effect," she said. "But a pessimist might ask, are things getting better?"

Read more: http://www.montrealgazette.com/health/Climate+change+doesn+have+cause+more+malaria/3049458/story.html#ixzz0oTmS8zRu